Blood thinners are medications prescribed to reduce the blood’s ability to form clots. These medications are important for preventing serious health conditions such as strokes, heart attacks, and deep vein thrombosis, which can arise from harmful blood clots forming in arteries and veins. While these medicines offer significant benefits by keeping blood flowing smoothly, they also increase the risk of bleeding. Understanding how to effectively manage bleeding is therefore important for individuals taking these medications.
How Blood Thinners Affect Bleeding
Blood clotting is a complex process involving various blood components and proteins, forming a plug to stop bleeding after an injury. Blood thinners interfere with different aspects of this natural process. Anticoagulants, for instance, work by targeting specific clotting factors, which are proteins in the blood necessary for coagulation. By disrupting the production or function of these factors, anticoagulants slow down the overall clotting cascade.
Antiplatelet medications, on the other hand, focus on platelets, which are small blood cells that play a primary role in forming the initial plug at a site of injury. Antiplatelets prevent these cells from sticking together and aggregating, thus inhibiting the formation of a clot. Because these medications reduce the blood’s natural ability to clot, even minor injuries can result in more prolonged or significant bleeding. While effective at preventing dangerous internal clots, they heighten the body’s susceptibility to external bleeding.
First Aid for External Bleeding
When external bleeding occurs, such as from a cut or scrape, the immediate response is to apply firm, direct pressure. For minor wounds, place a clean cloth or sterile gauze directly over the bleeding site. Maintain continuous pressure for a minimum of 15 minutes, as bleeding may be prolonged. If the bleeding does not subside after 15 minutes, continue applying pressure for another 15 minutes, or consider using an over-the-counter styptic powder or gel, which can help seal the wound and aid in stopping the bleeding.
Elevating the injured area above the heart can help reduce blood flow to the wound and assist in controlling bleeding. For example, raise a hand injury to shoulder height or elevate a leg injury by lying down and propping it up. Once bleeding stops, clean the wound with saline solution or a wound cleanser to prevent infection, then cover it with a clean bandage. If blood soaks through the initial dressing, do not remove it; instead, add more layers of gauze or cloth on top and continue applying pressure.
Nosebleeds are common and can be more significant for those on blood thinners. To manage a nosebleed, sit up and lean slightly forward to prevent blood from dripping down the throat. Pinch the soft part of the nostrils firmly together, just below the bony bridge, and hold for 10 to 15 minutes without releasing. Using a decongestant nasal spray in the bleeding nostril before pinching can sometimes help constrict blood vessels and reduce bleeding.
After the bleeding stops, avoid blowing the nose, lifting heavy objects, or engaging in strenuous activities for at least two days to prevent it from restarting. Never remove a blood clot that has formed on a wound, as this can dislodge the natural plug and restart bleeding.
Recognizing Serious Bleeding and When to Seek Help
While minor bleeding can often be managed at home, recognize when severe bleeding requires immediate medical attention. For external wounds, seek emergency care if bleeding is profuse, spurting, or does not stop after 30 minutes of continuous pressure. Deep, large, or dirty wounds warrant professional evaluation to prevent infection.
Internal bleeding, which may not be visible, is a significant concern for individuals on blood thinners. Signs of internal bleeding vary by location but often include unexplained bruising that appears suddenly or spreads rapidly. Head injuries, even minor bumps or falls, are concerning due to the risk of bleeding within the brain. Symptoms such as a severe or worsening headache, repeated vomiting, increasing confusion, vision changes, or difficulty staying awake require immediate emergency care.
Other indicators of internal bleeding include blood in bodily fluids or changes in their appearance. This could manifest as red or brown urine, indicating urinary tract bleeding, or black, tar-like stools or visible blood, suggesting digestive tract bleeding. Other general symptoms of significant blood loss or internal bleeding include unusual weakness, persistent fatigue, dizziness, lightheadedness, shortness of breath, or pale, cold skin. Any of these symptoms, especially after a fall or injury, necessitate immediate contact with emergency services or a visit to the nearest emergency department.
Reducing Your Risk of Bleeding
Individuals on blood thinners can take several steps to minimize their risk of bleeding and injury. Adopting gentle habits for daily care includes using a soft-bristled toothbrush and waxed dental floss to protect gums, and opting for an electric razor over a blade to prevent nicks and cuts. Wearing sturdy shoes, using protective gloves when handling sharp objects, and exercising caution with tasks that could lead to falls or impacts can help reduce injury risk.
When engaging in physical activity, choose lower-impact exercises like walking or swimming, and wear appropriate protective gear, such as helmets for cycling, to guard against head injuries. Discuss any new exercise routines or sports participation with a healthcare provider. Always inform any healthcare professional, including dentists and pharmacists, about all medications, vitamins, and herbal supplements being taken, as many can interact with blood thinners and increase bleeding risk.
Certain over-the-counter medications, particularly NSAIDs like ibuprofen or naproxen, can significantly elevate bleeding risk when combined with blood thinners. Many herbal supplements, including garlic, ginkgo biloba, fish oil, and St. John’s wort, possess blood-thinning properties and should be avoided or used only under medical supervision. For those taking warfarin, maintaining a consistent intake of vitamin K-rich foods is advisable, as large fluctuations can affect medication effectiveness. Alcohol and certain fruit juices, such as cranberry, grapefruit, and pomegranate, can influence how blood thinners work, making moderation or avoidance a prudent choice.